Department of Alcoholic Beverage Control
DAILY LICENSE APPLICATION/AUTHORIZATION - Non Transferable State of California
Gavin Newsom, Governor
ABC-221 (rev. 07/21)
Instructions: Complete all items.
Submit to local ABC District Office with required fee (Cashier's Check or Money Order) payable to ABC. Once license is issued, fee cannot be refunded. For a listing of ABC District Offices please visit http://www.abc.ca.gov/distmap.html Pursuant to the authority granted by the organization named below, the undersigned hereby applies for the license(s) described below.
LICENSE NUMBER
GEO CODE
RECEIPT NUMBER
FEE
$
1. ORGANIZATION'S NAME
CONDITIONS REQUIRED
Yes
No
DIAGRAM REQUIRED
Yes
No
2. LICENSE TYPE (Check appropriate license type AND organization type) a.
Daily General ($75.00)
(Includes beer, wine and distilled spirits)
Political Party/Affiliate Supporting Candidate for
Public Office or Ballot Measure
Organization Formed for Specific Charitable or Civic Purpose Other:
Fraternal Organization in Existence Over Five Years
with Regular Membership
Religious Organization
Vessel per Section 24045.10 B&P ($50.00)
b.
Special Daily Beer & Wine ($50.00)
Charitable
Civic
Fraternal
Religious
Social
Cultural
Political Other:
Amateur Sports Organization
c.
Special Temporary License ($100.00)
(Different privileges depending on statute)
Television Station per Section 24045.2 or 24045.9 B&P
Nonprofit Corporation per Sections 24045.4 and 24045.6 B&P Person conducting Estate Wine Sale per Section 24045.8 B&P Women's Educational and Charitable Organization per
Section 24045.3 B&P
Other Special Temporary Licenses, per Section
License number
Amount $
3. EVENT TYPE
Dinner
Dance
Wedding
Lunch
Picnic
Barbeque
Festival
Sports Event
Concert
Birthday
Mixer
Carnival
Dinner Dance
Social Gathering
Other:
4. TOTAL # OF DAYS
5. ESTIMATED ATTENDANCE
6. HOURS OF ALCOHOLIC BEVERAGE SALES, SERVICE AND/OR CONSUMPTION From To
7. EVENT DATE(S)
8. EVENT IS OPEN TO THE PUBLIC
Yes No
9. EVENT LOCATION (Give facility name, if any, street number and name, and city)
10. LOCATION IS WITHIN THE CITY LIMITS
Yes No
11. TYPE OF ENTERTAINMENT
12. SECURITY GUARDS
Yes
No
If yes, how many?
13. AUTHORIZED REPRESENTATIVE'S NAME
14. REPRESENTATIVE'S TELEPHONE NUMBER
15. REPRESENTATIVE'S ADDRESS
16. ORGANIZATION'S MAILING ADDRESS (If different from #15 above)
17. CONTACT EMAIL ADDRESS
18. AUTHORIZED REPRESENTATIVE'S SIGNATURE
19. DATE SIGNED
PROPERTY OWNER APPROVAL BY (Name), REQUIRED
PHONE NUMBER
PROPERTY OWNER SIGNATURE
DATE SIGNED
LAW ENFORCEMENT APPROVAL BY (Name), IF APPLICABLE
PHONE NUMBER
LAW ENFORCEMENT SIGNATURE
DATE SIGNED
DISTRICT OFFICE APPROVAL BY (Name)
ABC EMPLOYEE SIGNATURE
ISSUANCE DATE
The above-named organization is hereby licensed, pursuant to the California Business and Professions Code Division 9 and California Code of Regulations, to engage in the temporary sale of alcoholic beverages for consumption at the above named location for the period authorized above.
This license may be revoked summarily by the Department if, in the opinion of the Department and/or the local law enforcement agency, it is necessary to protect the safety, welfare, health, peace and morals of the people of the State.
ATTACHMENT 3